Texas Association of Student Councils (“TASC”)
BOARD OF DIRECTORS
Annual Statement of Disclosure
I, ______________________________ (name printed), have read the Conflict of Interest Policy of TASC.
To the best of my knowledge and belief, neither I nor any person or organization with whom I have a
personal or business relationship is engaged in any transaction or activity that may represent a conflict with
my obligations to TASC.
To the best of my knowledge and belief, neither I nor any person or organization with whom I have a
personal or business relationship intends to engage in any transaction, to acquire any interest in any
organization or entity, or to receive any substantial gift or favor that may represent a conflict with my
obligations to TASC.
To the best of my knowledge and belief, I do not expect to receive compensation from TASC, or to receive
in excess of $10,000 annually from TASC for services I provide to TASC as an independent contractor,
other than reimbursement of reasonable expenses.
To the best of my knowledge and belief, no member of my family expects to receive any compensation or
material financial benefit from TASC.
To the best of my knowledge and belief, I have no family relationship or business relationship with any
current member of the Board of Directors, any officer, or any key employee of TASC.
Any exceptions to the statements made herein are disclosed in full below.
Without Exception ____ (initial)
With Exception as Described Below ____ (initial)
Signature __________________________ Date _______________
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